I was abroad on vacation when I was having sex with someone I did not know and the condom broke. I was scared they might have HIV so the doctors prescribed me PEP of Truvada and Kaletra. Since I would return to America in less than a week, and I did not have insurance abroad they advised me only to receive enough pills (Truvada) for 2 weeks while abroad and get the rest at home to avoid the expensive cost of getting the full dose without insurance. (They gave me the full dose of Kaletra.) They told me to get the second half of Truvada back at home but told me that if my care provider denies me the second half of Truvada, then I should just take the Kaletra alone and I should be fine. Im reading online that taking both medications for the full 28 days is necessary for the drugs to be effective. Is there truth to what the doctor was saying about just finishing the Kaletra, or should I seek out the rest of the Truvada no matter what? Thanks.

Response from Dr. Young

Hello and thanks for posting your question about PEP.

Here in the US, we'd typically use a three drug regimen for PEP. PEP after sexual exposure is called non-occupational PEP or nPEP. Our current US governmental guidelines are dated (from 2005) but recommend Truvada with either efavirenz (Atripla) or Kaletra. Both of these "3rd drugs" have a risk of side effects, and more recent NY State guidelines recommend using Isentress with Truvada. It's far better tolerated, and covers the ~10% of transmitted viruses that are resistant to efavirenz.

In either case, completing the last two weeks of your PEP with just Kaletra, while non-conventional, will likely have activity against any virus you may have been exposed to.

I'd probably just finish the treatment course with the Kaletra. Make sure that you get HIV antibody testing at 1 and 3 months after the exposure.

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